Resident of Elk Grove senior home where woman died last week tests positive for coronavirus

Every day for the past week, Darlene Lyttle has called, messaged and Facetimed her 79-year-old father, a resident at Carlton Senior Living in Elk Grove.

She’s anxiously tried to learn what’s happening at her dad’s assisted living facility, where officials over the weekend announced that a second resident had tested positive for the new coronavirus and that all residents were ordered to isolate themselves indefinitely.

Lyttle, who lives in Galt, has grown increasingly frustrated the facility will not explain how many of her dad’s roughly 140 neighbors have been tested for COVID-19. That’s stoking her concerns about what might happen in the coming — and increasingly uncertain — days ahead.

“I think that if you have a nursing home or a facility like this that has someone test positive, that’s a stop, drop and roll,” Lyttle said Monday. “I would think that you would stop and test everyone there because you have a positive. Maybe they are as soon as they have kits available. They haven’t told us. They haven’t communicated how they’re doing it.”

Carlton Senior Living in Elk Grove has been a focus for health officials since a resident in her 90s contracted the disease and died last week. It was the first death in the county tied to the new coronavirus and apparently the first confirmed COVID-19 case in a California senior facility. People, including Lyttle, speak fondly of the facility.

Records also show Carlton’s Elk Grove facility in the past has dealt with at least one infectious disease outbreak and has been cited by the state for improperly distributing medication, allowing a cognitively impaired resident to walk away and for leaving another resident out in the sun during a blazing summer day.

A spokeswoman for Carlton Senior Living did not return a call seeking comment for this story.

But in a statement over the weekend, officials with the facility reiterated the steps they were taking to protect those who call Carlton home.

“We understand that everyone would like to know where this started, who the resident is and how the infection developed,” Carlton officials wrote. “As you know, it is our responsibility to protect the privacy of all our residents.”

Carlton Senior Living is not a nursing home and instead houses its residents in apartment-style units, according to its most recent inspection documents. In addition to isolating residents to their units, Carlton has also canceled all group activities, blocked visitation, started screening all employees and ceased food service in the shared dining room.

“We do understand that restricted visitation can be very difficult on our families and the residents,” facility officials said. “Please understand that we would not ask this if it was not for the safety and the well-being of our residents and employees.”

Tests in March, concerns of an outbreak

After a woman in her 90s tested positive for COVID-19 last week and later died, Sacramento County Public Health began testing those who came in close contact with her.

Three tests immediately after the death last week came back negative.

But the glimmer of good news revealed a crack in the government’s response to a pandemic: While counties rely on testing to detect hot spots and coordinate responses, many are still struggling to administer enough tests altogether.

In an interview with The Bee late last week, county health chief Dr. Peter Beilenson lamented the lack of tests and said in a follow-up interview the county could only test 25 to 30 people a day. He would not say how many people at the Elk Grove facility were being tested but lauded the steps Carlton Senior Living was taking.

“They still are obviously a priority,” Beilenson said. “What we did was test going out from the central case (the ill person). I don’t know if they are done yet.”

Later in the week, “one returned positive,” Carlton Senior Living wrote in a statement posted to its website over the weekend. The resident has since been isolated in their apartment and is being monitored by Sacramento County Public Health.

County officials, by policy, have declined to offer details on the cases. Officials are citing patient confidentiality in declining to disclose details and say most of the cases are “community spread,” meaning they were contracted by contact with others in the county, not via travel or contact with someone who recently traveled.

Even with limited testing capacity, at least 33 people had tested positive for COVID-19 in Sacramento County by Monday afternoon. The county also announced its second death linked to the disease, a person in their 70s who also had underlying health conditions.

More than 181,000 people globally had tested positive for the coronavirus, with increasingly growing pockets outside of China, according to a map maintained by Johns Hopkins University. That country has also suffered the majority of more than 7,100 deaths globally, though Italy’s death toll has rocketed in recent days, to at least 2,100.

Lyttle, whose dad is in the Elk Grove facility, spoke to her dad Monday morning. He said a new nurse was tending to him and didn’t know his exact medication dosage.

She called to get answers.

A nurse who didn’t normally work Monday was tending to him, she learned, and together they got the discrepancy sorted. But it made her fear the facility was becoming short-staffed. And if visitation restrictions and sporadic quarantines are going to be in place for the foreseeable future, Lyttle hopes communication gets better, too.

“Nobody was prepared for this. I can’t throw rocks. I think they’re just learning on the curve like everyone else is,” she said of Carlton. “I realize that there’s probably a bottleneck somewhere, but they should be telling us and keeping us abreast of it.”

‘Outbreak’ in 2016

The Elk Grove facility has had a brush with an outbreak before.

In January 2016, the California Department of Social Services investigated a complaint that Carlton “failed to protect residents from reoccurring outbreaks” and that food service during the event “did not meet the needs of the residents,” according to a complaint investigation report.

It was the second time in six months that regulators were alerted to sickness related to gastrointestinal issues at the assisted-living facility.

Although the report does not say what kind of outbreak occurred, the symptoms associated with the illness included vomiting and dizziness. The California Department of Public Health reported dozens of norovirus outbreaks from late 2015 and into 2016, a condition that shares the same signs of illness seen at Carlton.

Noroviruses are very contagious and can spread from person-to-person and on unclean surfaces, according to the Centers for Disease Control and Prevention.

Investigators determined that the outbreak infected at least 10 residents and a “handful of staff” records show. However, the allegations were deemed unfounded. Regulators said Carlton recognized the outbreak and came up with measures to control the cluster of infections.

The facility has had 13 “Type A” citations, meaning there was immediate health, safety or personal rights violation involved since 2015. The average for all residential elder care facilities in Sacramento County is less than three, a review of state data by The Bee shows.

An incident from May 2017 is among the more severe complaints, documents show. A resident was left out in the sun for nearly three hours and was found overheated and unresponsive. Staff also provided the hospital with an outdated end-of-of life plan that had changed from “attempt to resuscitate” to “do not resuscitate.”

Carlton officials agreed to further training to notice heat-related illness, better awareness of hot days and added hydration stations in the memory care and assisted living wards.

And the facility was also cited for an incident that happened in April when a person with a cognitive impairment walked out the front door alongside members of a band that had been playing for residents, records show. Facility staff called the police, who found the person a quarter-mile away, and he was moved to a more secure memory care unit the following week as staff underwent additional training.

There do not appear to have been any other infectious disease outbreaks since the apparent norovirus sickness five years ago.

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This story was originally published March 16, 2020 at 4:18 PM.